Scoring System to Predict Malignancy for MRI-Detected Lesions in Breast Cancer Patients: Diagnostic Performance and Effect on Second-Look Ultrasonography
Purpose To design a scoring system to predict malignancy of additional MRI-detected lesions in breast cancer patients. Materials and Methods Eighty-six lesions (64 benign and 22 malignant) detected on preoperative MRI of 68 breast cancer patients were retrospectively included. The clinico-radiolo...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
The Korean Society of Radiology
2020-03-01
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| Series: | 대한영상의학회지 |
| Subjects: | |
| Online Access: | https://doi.org/10.3348/jksr.2020.81.2.379 |
| Summary: | Purpose To design a scoring system to predict malignancy of additional MRI-detected lesions
in breast cancer patients.
Materials and Methods Eighty-six lesions (64 benign and 22 malignant) detected on preoperative
MRI of 68 breast cancer patients were retrospectively included. The clinico-radiologic features
were correlated with the histopathologic results using the Student’s t-test, Fisher’s exact
test, and logistic regression analysis. The scoring system was designed based on the significant
predictive features of malignancy, and its diagnostic performance was compared with that of
the Breast Imaging-Reporting and Data System (BI-RADS) category.
Results Lesion size ≥ 8 mm (p < 0.001), location in the same quadrant as the primary cancer (p =
0.005), delayed plateau kinetics (p = 0.010), T2 isointense (p = 0.034) and hypointense (p = 0.024)
signals, and irregular mass shape (p = 0.028) were associated with malignancy. In comparison with
the BI-RADS category, the scoring system based on these features with suspicious non-mass internal
enhancement increased the diagnostic performance (area under the receiver operating
characteristic curve: 0.918 vs. 0.727) and detected three false-negative cases. With this scoring
system, 22 second-look ultrasound examinations (22/66, 33.3%) could have been avoided.
Conclusion The scoring system based on the lesion size, location relative to the primary cancer,
delayed kinetic features, T2 signal intensity, mass shape, and non-mass internal enhancement
can provide a more accurate approach to evaluate MRI-detected lesions in breast cancer patients. |
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| ISSN: | 1738-2637 2288-2928 |